by Natalie J. Dahl, M.S., CCC-SLP
Did you know a child swallows 2,000 times each day? Now imagine if
every time a child swallows, his tongue pushes against his front teeth…
that’s 2,000 times every day that his teeth are pushed against and
slightly moved forward! This habit is called tongue thrust and it can
cause problems for dentition, biting, chewing/eating, and sometimes
What is tongue thrust? Tongue thrusting is the habit of pushing the tongue against or between
the front teeth when swallowing and/or speaking. It is also commonly referred to as a
reverse or immature swallow and is normal in infants and toddlers. Normally, children
will outgrow this pattern of swallowing; however, if they do not, a trained speechlanguage
pathologist (SLP) can help re-train the muscles to a normal swallowing pattern.
What causes tongue thrust? There are several possible causes of tongue thrust: oral habits (e.g., thumb sucking,
fingernail biting, lip picking, teeth clenching and grinding), allergies, enlarged tonsils
and adenoids, and/or hereditary factors.
What are the effects of tongue thrust?
Speech: If speech is affected, the sounds most likely produced incorrectly are S,
Z, SH, ZH, J, and/or CH. For example, a child may say “thun” instead of “sun”
because his/her tongue is too far forward while speaking. Also, the sounds T, D, N,
and L may be distorted because of weak tongue tip muscles. Sometimes, however,
speech may not be impacted at all.
Dentition: Because the tongue is pushing excessively on the front teeth, the teeth
may be repositioned forward and upward into an open bite. An open bite occurs
when a child bites his/her back molars together but the front top and bottom
teeth do not touch. Tongue thrust can reverse orthodontic work that has already
Eating: A child with tongue thrust will often chew food with his/her lips
open, take large bites, and swallow before completely
chewing the food. This can lead to noisy chewing and
swallowing and a messy eating area. It may also cause an
upset stomach from swallowing too much air while eating.
Can tongue thrust be corrected?
Tongue thrust can be diagnosed by a dentist, an orthodontist, a
doctor, or SLP. An SLP can create a therapy plan to help remediate
tongue thrust. This plan might include goals to:
- decrease unwanted oral habits (e.g., thumb sucking)
- improve awareness of muscles used in the mouth and face
- improve awareness of mouth and tongue postures
- improve muscle coordination and strength
- improve articulation skills
- improve swallowing patterns
In order to qualify for therapy services at school from an SLP, a child’s disability has to
negatively impact access to his/her education. Tongue thrust alone most likely will not
have this adverse impact; however, if the tongue thrust is causing articulation errors, a
child may be eligible to receive speech therapy at school. Contact your local SLP if you
are interested in learning more about tongue thrust and/or articulation therapy.